Objective:This observational analysis aimed to explore the association between gut microbiota and brain axis in pancreatic cysts and assess the impact of this association on clinical outcomes. Methodology:This retrospective cohort study was conducted at Dicle University Faculty of Medicine, Diyarbakır, Turkey. Forty-seven patients (serous cystadenoma n=16, mucinous neoplasm n=31) treated at a single center between 2015 to 2023 were included in the study. Microbiota analysis (16S rRNA sequencing) of stool samples, biochemical and hormonal parameters from blood samples were evaluated. Depression-anxiety scales and cognitive tests were also performed. Results:Microbiota diversity in the mucinous neoplasm group (Shannon index: 2.9±0.6) was significantly lower than in the serous cystadenoma group (3.8±0.5) (p=0.012). Firmicutes/Bacteroidetes ratio (2.89±0.5), inflammatory markers (CRP: 4.2±4.8 mg/dL) and depression scores (Beck: 18.6±6.4) were significantly higher in mucinous neoplasm patients (p<0.05). Two-year overall survival rates were 100% in the serous cystadenoma group and 80% in the mucinous neoplasm group (p=0.015). Conclusion:The microbiota-brain axis has an important role in pancreatic cysts. Microbiota imbalance, increased inflammation and high depression-anxiety levels observed especially in mucinous neoplasms suggest potential targets for future therapeutic interventions in this patient group.

OBJECTIVE:This study aims to compare conventional and laparoscopic living donor nephrectomy procedures performed in our hospital in terms of clinical and laboratory findings, morbidity, and mortality for donors and recipients. METHODS:Recipients were categorized into 2 groups according to the surgical approach taken to procure the graft transplanted to them. Variables that are compared include demographic information, number of mismatches, underlying pathology, length of hemodialysis, crossmatch results, nephrectomy side, side of the transplant, number of donor arteries/veins/ureters, preoperative /intraoperative /postoperative immunosuppression protocols, urea, creatine and glomerular filtration rate values at preoperative /postoperative /discharge times, first month and year creatine levels, hospital stay lengths, postoperative complication, rejection, and mortality rates. FINDINGS:In the recipient patient group, the warm and cold ischemia times of the grafts in the LDN group were found to be significantly longer than those in the ODN group (P < .001 and P = .002). The LDN group had higher complication rates compared to the ODN group (P = .004). In the donor group, hospital stay duration was shorter for patients who underwent LDN (P = .021). When examining graft rejection and function, chronic rejection was found to be higher in grafts with ODN (P = .004). Grafts with higher warm and cold ischemia times had worse 1-year creatinine change outcomes (P = .009, P = .013). CONCLUSION:The LDN procedure increases the warm and cold ischemia times of the graft compared to ODN. However, it does not significantly affect graft survival and kidney function in long-term follow-ups.

Purpose Polymeric clips (Hem-o-lok ligation system) are now widely used to securing the base of the appendix during laparoscopic appendectomy. Studies comparing the use of single or double hem-o-lok clips are limited. The aim of this study was to compare the reliability of a single hem-o-lok clips with a double hem-o-lok clips for closure of an appendiceal stump. Methods This prospective randomized study includes patients from two centers who underwent laparoscopic appendectomy with the diagnosis of appendicitis between September 2020 and March 2023. Demographic, operative and clinical outcomes of the use of single or double hem-o-lok clips for closure of the appendiceal stump were compared. Factors affecting long postoperative hospital stay were investigated using univariate and multivariate analyzes. Results One hundred forty two (48.3%) patients in the single hem-o-lok arm and 152 (51.7%) patients in the double hem-o-lok arm were included in the analysis.The shortest operative time was noted in the single hem-o-lok group (52.1 ± 19.9 versus 61.6 ± 24.9 min, p < 0.001). The median hospital stay was 1 day (range 1–10) in the single hem-o-lok group and 1 day (range 1–12) in the double hem-o-lok group, and was shorter in the single hem-o-lok arm (1.61 ± 1.56 vs 1.84 ± 1.69, p = 0.019). Based on multivariate analysis, drain placement was identified as an independent predictive factor for long hospital stay. Conclusions The use of single hem-o-lok clips for appendiceal stump closure during laparoscopic appendectomy is safe and effective. Trial registration NCT04387370 ( http://www.clinicaltrials.gov ).

Aim The effects of conversion to open surgery during laparoscopic resection in rectal cancer on perioperative clinical and long-term oncological outcomes are still controversial. This study aimed to evaluate and compare the impact of conversion to laparoscopic resection for rectal cancer on perioperative and long-term oncological outcomes. Material and methods Between January 2019 and December 2023, 84 consecutive patients who underwent curative surgery for rectal cancer at a single academic center were evaluated retrospectively. Patients were classified and compared as the laparoscopic (LAP-G) and converted (CONV-G) groups. Perioperative, pathological, and long-term oncological outcomes were compared. Results Of the 84 consecutive patients included, 18 were converted to open surgery, leading to a 21.4% conversion rate. Intraoperative blood loss was higher in CONV-G (180 ml vs. 80 ml, p<0.001), but early clinical outcomes were similar in both groups. The median follow-up period was 23.5 (range 3-65) and 30.5 (range 6-61) months in the LAP-G and CONV-G, respectively, and recurrence occurred in 11 (16.7%) and 3 (16.6%) patients, respectively. Three-year overall survival was 96.9% and 89.4% (p=0.609) and 3-year disease-free survival was 92.4% and 83.3% (p=0.881) in LAP-G and CONV-G, respectively, and the results were similar. Conclusion Conversion from laparoscopic rectal resection to open surgery does not have a significant negative impact on morbidity and long-term oncological outcomes.

Objective: This study was performed to investigate the prognostic role of lactate dehydrogenase/albumin ratio (LAR) and pancreatic ductal adenocarcinoma (PDAC) with initial curable resection treatment. Materials and Methods: This retrospective study was conducted with the data of patients with resectable PDAC. The (ROC) analysis showed that the optimal sill value for pretreatment LAR was 91.43 and this threshold value was used in other analyses. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS). Results: Our study consisted of 70 patients with a mean age of 59.5±13.2 years and 37 (52,9%) women. OS was 50 months in LAR <91.43 (n = 32) patients and 27,7 months in LAR≥91.43 (n=38) patients, respectively. Kaplan–Meier curves showed that LAR≥91.43 was significantly associated with worse OS (p=0.029). Multivariate analyses proved that LAR was an independent predictor in resectable PDAC patients (p=0.017). Conclusion: Our results showed that a high pre-treatment LAR level was a unfavorable prognosticator in PDAC patients undergoing curative resection. LAR has the potential to be a prognostic biomarker in clinical practice.

Background: Maintaining collateral circulation is highly important in the stenosis of celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The SMA compression is commonly reported to be accompanied by the CA compression caused by the median arcuate ligament (MAL) while the synchronous compression of CA and SMA by other ligaments has been rarely reported.Case Presentation: In this report, we present a 64-year-old female patient who presented with a postprandial abdominal pain and weight loss. Initial evaluation indicated a synchronous compression of CA and SMA caused by MAL. The patient was planned for laparoscopic MAL division due to the presence of sufficient collateral circulation between the CA and SMA that was facilitated through the superior pancreaticoduodenal artery. Following laparoscopic release, the patient improved clinically and postoperative imaging indicated that the compression on the SMA was still present and the collateral circulation was sufficient.Conclusion: We suggest that laparoscopic MAL division can be the primary method of choice in cases with sufficient collateral circulation between the CA and SMA.

Aim: The operation of choice for obstructed carcinoma of the left-side colon with perforation on the cecum is controversial.This study evaluated the timing of subtotal/total colectomy in acutely obstructed carcinoma of the left-side colon with perforation on the cecum.Method: Twelve patients with cecal perforation due to obstructed left-side colon tumor were included in this study.The patients were evaluated for age, gender, application time, presence of systemic diseases, Acute Physiology and Chronic Health Evaluation II scores, primary tumor localization, tumor stage, type of surgical operation, Mannheim Peritonitis Index, morbidity, and mortality.Results: Seven adenocarcinomas were localized on the left colon, three were localized on the midsigmoid, and two were localized on the rectosigmoid junction.All patients had a massively distended colon with perforation on the cecum.Seven patients underwent subtotal colectomy, while five patients underwent total colectomy.After the resection, anastomosis was performed using a circular stapler.After anastomosis, loop ileostomy was performed on the right side of the abdomen for all patients for anastomosis safety. Conclusion:This study suggests that resection, anastomosis, and protective loop ileostomy are viable surgical alternatives, even in emergency conditions, if they can be performed together with decompression and peritoneal lavage in the surgical treatment of cecum perforation due to obstructed left colon tumors.

Abstract Aim: Acute pancreatitis is a serious disease, with an incidence of 5 - 35 in 100,000 individual. New studies are constantly planned for the treatment of pancreatitis. Many studies have shown that Rosmarinic acid has antioxidant properties. In this study, we examined the protective effect of Rosmarinic acid on acute pancreatitis. Material and Methods: A total of 28 animals were used during the experiment, and 4 groups were formed with 7 animals in each group. Group 1 is the control group. The rats in Group 2 were administered 75 μg/kg Cerulein every hour intraperitoneally at one hour intervals, a total of four times. Group 3 experimental animals were given 50 mg/kg Rosmarinic acid by per oral gavage. The rats in group 4 were given 50 mg/kg Rosmarinic acid per oral gavage after 75 μg/kg Cerulein was injected intraperitoneally every hour for a total of four times. Afterwards, all animals were sacrificed by exsanguination, blood samples and pancreatic tissue were taken for examination. Results: Examination of pancreatic tissues revealed necrosis, edema and inflammation in the acute pancreatitis group. Both histopathological and serum values of the rosmarinic acid group were close to the control group. The use of Rosmarinic acid after acute pancreatitis had a positive effect on the pacreatic tissues and blood values, but still did not cause complete recovery. Conclusion: In the case of acute pancreatitis, it was concluded that rosmarinic acid has a partial curative effect, but still does not provide a full recovery.

Objective: Small bowel tumors are rare lesions and they constitute less than 5% of all gastrointestinal system (GIS) tumors.Diagnosis of small bowel tumors is very difficult due to nonspecific clinical findings.The aim of this study is to evaluate the data of patients with primary small bowel tumors who underwent surgical treatment in our clinic.Methods: Thirty-five primary small bowel tumor cases operated in Dicle Hospital between January 2011 and December 2020 were retrospectively analyzed.The patients were evaluated in terms of age, gender, admission complaint, operative finding, surgical method, pathological findings, morbidity and mortality.The results of the patients were obtained from th e file records and/or interviews with the patients.Results: Twenty-two (62.9%) cases were female and 13 (37.1%)were male, with a mean age of 53.9 (21 -79).Abdominal pain was present in all cases.Abdominal distension was seen in 15 (42.9%) cases, vomiting in 10 (28.6%) cases, invagination findings in 5 (14.3%) cases, GIS perforation in 4 (11.4%)cases, GIS bleeding in 2 (5.7%) cases.Abdominal computed tomography (CT) was used as the imaging method in all patients.The mean time between the onset of complaints and diagnosis was 1.6 (1-15) months.Laparoscopic surgery was used in six (17.1%) cases, and open surgery was used in others.Tumors were mostly located in the jejunum (68.6%).The most common type was adenocarcinoma (34.3%) detected in the post operative histopathological examination.Mortality was observed in 3 (8.6%)cases in the 6-month postoperative follow-up.Conclusion: Small intestinal tumor is a rare condition.Preoperative diagnosis is difficult due to the nonspecific nature of the symptoms.If there is high doubt in the diagnosis, surgical intervention should not be postponed.

OBJECTIVE: To investigate the effect of sildenafil on reducing the impact of hepatic ischemia/reperfusion (HIR) injury established by Pringle maneuver on the heart of rats. STUDY DESIGN: Forty Wistar albino rats were divided into 4 groups: Sham (laparotomy only), Control (laparotomy following sildenafil application), IR (ischemia/reperfusion injured by HIR), and IR+ SIL (injured by HIR following sildenafil application). Ischemia was developed by clamping the hepatoduodenal ligament for 30 minutes; then reperfusion was applied for 30 minutes. Sildenafil (single dose of 50 mg/kg) was administered by oral gavage for 15 minutes before ischemia. Blood samples of rats were collected from Sham and Control groups at 60 minutes and from IR and IR+ SIL groups at 30 minutes after initiation of reperfusion for biochemical analysis. Meanwhile, heart tissues were sampled for biochemical analysis. Malondialdehyde (MDA) and total antioxidant capacity (TAC) in serum samples and TAC, total oxidative capacity (TOC), and oxidative stress index in heart tissues were examined biochemically. RESULTS: Serum MDA levels were elevated significantly in the IR and IR+ SIL groups as compared to the sham group. Sildenafil treatment inhibited MDA increase considerably in the IR+ SIL group as compared to the IR group. Serum TAC levels were elevated significantly in the sildenafil and control groups (compared with sham groups) and in the IR+ SIL group (compared with the IR group). TAC levels detected in heart tissue increased significantly in the IR group as compared to the sham group; however, sildenafil treatment had no effect on this increase. CONCLUSION: Heart tissue was affected by HIR. It was revealed that sildenafil treatment may prevent the oxidative stress via increasing serum TAC levels in both control and IR+ SIL groups.

Background: Tumors that occur in the retrorectal space are called retrorectal tumors. These tumors arise from various tissues. Late symptoms may therefore outweigh diagnosis and treatment. Therefore, the surgery becomes difficult. Aims and Objectives: Our study aims to reveal the difficulties in the diagnosis of retrorectal tumors, radiological diagnostic methods, and safe surgical excision surgical techniques. Materials and Methods: Twelve patients operated for retrorectal tömür between 2014 and 2020 were included in the retrospective study. Demographic features, clinical findings, diagnostic methods, surgical treatment procedures, evaluations of preoperative/postoperative complications, pathological classifications, length of hospital stay, and duration of surgery were studied. Results: Twelve patients [9 females, 3 males; the mean age was 39.3 ± 11.8 (22-56)] due to retrorectal tumors. All lesions were evaluated preoperatively using magnetic resonance imaging (MRI). According to the preoperative examination and radiological findings; Surgical resection was performed with an anterior approach to 3 patients, a posterior approach to 4 patients, and a combined approach to 5 patients. The mean tumor size was 8 ± 2.24 cm. Immature teratoma and epidermoid cyst (n = 6) were the most common tumors. We did not have any patients with features of malignancy on final histopathology. Conclusion: Although retrorectal tumors are difficult to diagnose, it is important to suspect clinically. A good evaluation of the patients with radiological imaging facilitates the resection of the tumor surgically. Surgery of the patient in centers specialized in these tumors increases surgical success.

Background: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. Aim: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients with MALS. Materials and Methods: The data of ten patients with MALS who were subjected to laparoscopic sectioning of the MAL were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic test findings, American Society of Anaesthesiologists score, operative findings and complications and mortality, hospital stay duration and hospital readmission. The diagnosis of MALS was established by computed tomography (CT) angiography. Results: Six (60%) of ten patients with MALS were female and four (40%) were male. The mean age was 42.4 ± 12.3. The main symptoms were epigastric pain (100%) and weight loss (60%). CT angiography showed high-grade stenosis of the anterior wall of the proximal coeliac trunk and post-stenotic dilation caused by extrinsic compression of the MAL. Surgical procedure was uneventful in all patients. Operating time was 155.5 min (120–200) and intra-operative blood loss was 150 ml (100–250). Length of stay was 3.1 day (2–9), with no mortality. The post-operative complications developed in two female patients. One of them developed ileus and the other patient developed pulmonary thromboembolism. At 6-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic decompression is an effective treatment for MALS and can provide symptomatic relief. This method may be the preferred modality of treatment in view of its lack of morbidity and good results.

The objective of the study was to evaluate the serum levels of tumour necrosis factor (TNF)‐α, interleukin (IL)‐1β and IL‐6 in chronic HBV‐infected patients.

Objective: The aim of this study is to reveal the efficacy of laparoscopic sleeve gastrectomy (LSG) in the preventable metabolic consequences of morbid obesity. We evaluated the weight loss according to body mass index (BMI), changes in comorbid diseases accompanying obesity in patients who underwent surgery in our clinic in the early and mid-period postoperatively, whether there was vitamin deficiency in the mid-term, and the complications associated with the surgery. Methods: In this study, a total of 50 patients aged 18-60 who underwent LSG intervention due to morbid obesity between January 1, 2010 and December 2019 by Dicle University School of Medicine, General Surgery Clinic, were retrospectively evaluated. Sociodemographic data of the patients, preoperative BMI, postoperative 3th month, 6th month and 1st year BMI values, preoperative and postoperative 12th month HgA1c levels were measured. Mortality and complication rates were evaluated. Results: The mean BMI of 50 patients at pre-LSG, postoperative 3rd month, 6th month and 1st year controls were respectively; 45.83±6.37, 37.63±5.88, 31.91±5.10 and 26.82±3.08kg/m2. Compared to before the intervention, the decrease in BMI was significant at the 3rd month, 6th month and 1st year controls (p <0.05). When paired comparisons were made, the BMI at the 1st year control was lower than the 6th and 3rd month (p<0.05). It was found that the preoperative HbA1c level of 6.55±1.37 decreased to 5.32±0.57 in the postoperative 12th month (p<0.05). Complication rate was determined as 2%. No mortality was observed during the follow-up. Conclusion: As a result of this study, it has been shown that LSG provides sufficient weight loss. In addition, LSG was found to be effective in achieving glycemic control and remission in Type 2 diabetes. In this study where mortality was not observed, LSG, which is a reliable method with acceptable operation time and postoperative complication rates, seems to be an effective solution in the surgical treatment of obesity. However, there is a need for more comprehensive randomized studies evaluating the long-term results of LSG.

BACKGROUND Colonic lipomas begin to be symptomatic when they reach a certain size, although the presentation can vary. In this study, we aimed to evaluate our experiences with the management of patients who presented with symptomatic giant colonic lipomas. METHODS The data of 7 patients with single colonic lipoma were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic findings, American Society of Anesthesiologists (ASA) score, operative findings, postoperative complications, mortality, hospital stay duration, and hospital readmission. The diagnosis of colonic lipoma was established by computed tomography (CT). RESULTS In this study, 4 (57.1%) of 7 patients with colonic lipoma were female, and 3 (42.9%) were male. The mean age was 56.7 years (range, 45-69). The main symptoms were abdominal pain (100%), and constipation (71.4%). The findings of intestinal occlusion detected on CT confirmed the diagnosis in all patients. Colon lipoma was located in the ascending colon in 2 patients, in the hepatic flexure in 2 patients, in the transverse colon in 2 patients, and in the cecum in 1 patient. The surgical procedure was uneventful in all patients. Four (57.1%) patients underwent laparoscopic colonic resection, while in the remaining 3 (42.9%) patients, a laparotomy was performed. The mean operating time was 185.7 min (150-210). Length of stay was 7.1 days (6-10), with no mortality. The mean diameter of the lesions was 7.4 cm (6-9). At a 6-month follow-up, all patients were asymptomatic with no signs of recurrence. CONCLUSION Although colon lipomas are rare, they are of great importance because they can be symptomatic and can be confused with colon malignancies in the differential diagnosis. Being able to make a definitive preoperative diagnosis will change the surgical strategy. A minimally invasive surgical approach should be employed to resect symptomatic colonic lipomas with an experienced surgical team in eligible patients whenever possible.

Objective:Rectal prolapse is a rare condition characterized by protrusion of the rectum with all its layers from the anus. It is a disease that causes social and functional problems. In this study, it was aimed to investigate the abdominal and perineal approaches together with postoperative early and late results in our patients who underwent surgical treatment for rectal prolapse.Method:The records of 39 patients who were operated on with the diagnosis of rectal prolapse between 2010 and 2020 in the Department of General Surgery, Dicle University Faculty of Medicine were evaluated retrospectively. Demographic and physical examination findings of the patients, surgical methods applied, early and late postoperative complications, recurrence and mortality rates were recorded.Results:The most common complaints on admission to the hospital were gas control disorder, difficulty in defecating and getting wet with mucus. On physical examination, stage 1 rectal prolapse was found in 12.8% of the patients, and full-thickness prolapse was found in the other patients. The mean age of 39 patients included in the study was 36 (14-88) years. Of the patients included in the study, 14 (35.9%) were female and 25 (64.1%) were male. Surgery was performed with an abdominal and perineal approach in 53.8% of the patients, while laparoscopy was performed in 46.2%. The most frequently used abdominal surgical technique was Notaras (35.8%). The most common perineal approach technique was Altemeier (5.1%). Patients who underwent the perineal approach were older and had a shorter hospital stay, and it was often performed under regional anesthesia. Complications developed in the early postoperative period in 10.4% of the patients. The median hospital stay was 5 days (2-19) and the follow-up period was 13 months (9-19). Postoperative mortality did not occur in any of the patients. Hospital stay was significantly shorter in patients who underwent laparoscopic surgery. There was no statistical difference in terms of early postoperative complications and recurrence.Conclusion:Although more than a hundred surgical procedures have been described to date for the treatment of rectal prolapse, the ideal treatment method is still unclear. In terms of surgical treatment, the results of abdominal or perineal approaches to be applied are similar, considering the risk factors, patient findings and surgeon’s experience.

Abstract Aim The present study aimed to investigate the effect of the presence of polyposis in sporadic early-onset colorectal cancer (EOCRC) on clinicopathological and oncological outcomes. Methods The retrospective study included patients with sporadic colorectal cancer aged 16 to 50 years who underwent curative resection at the general surgery clinics in two healthcare centers between 2013 and 2019. Patients were divided into two groups: polyposis and nonpolyposis. Clinicopathological characteristics and oncological outcomes were compared between the two groups. Results A total of 127 patients were included, of whom 60.6% were men. There were 25 (19.68%) patients in the polyposis group and 102 (80.31%) patients in the nonpolyposis group. Seventy-one (69.6%) of the nonpolyposis group and 23 (92.0%) of the polyposis group had adenocarcinoma histological types. The total number of patients with mucinous tumor and signet ring cell carcinoma in the nonpolyposis and polyposis groups was 31 (30.4%) and 2 (8.0%), respectively (p = 0.042). Five-year overall survival (OS) was 60 and 72% in the nonpolyposis and polyposis groups, respectively, and no significant difference was found (p = 0.332). In univariate analysis, American Joint Committee on Cancer (AJCC) tumor stage (pT) ≥3–4, lymph node positivity, presence of mucinous tumor and signet ring cell carcinoma, lymphovascular invasion, and advanced tumor-lymph nodesmetastasis (TNM) stage (III–IV) were found to be significant negative prognostic factors for OS, whereas none of these parameters were found to be prognostic factors in multivariate analysis. The presence of polyposis was not a significant factor on both univariate and multivariate analyses. Conclusion Although the sporadic EOCRC cases developing on the basis of polyposis can have slightly better oncological outcomes, these outcomes are mostly similar to those of cases with nonpolyposis. How to cite this article Aday U, Kafadar MT, Oğuz A, et al. Polyposis and Oncologic Outcomes in Young-onset Sporadic Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2021;11(1):6–10.

AIM OF THE STUDY:To investigate the prognostic role of lactate dehydrogenase-to-albumin ratio (LAR) in gastric cancer patients undergoing curative resection. MATERIAL AND METHODS:A retrospective study was conducted including resectable gastric cancer patients. According to the time-dependent receiver operating characteristics (ROC) analysis, the optimal threshold for pretreatment LAR was 5.5. The Kaplan-Meier method, Cox regression univariate and multivariate analyses were used to analyze the prognostic factors for disease-free survival and overall survival (OS). RESULTS:The study cohort consisted of 81 patients, mean age was 60.2 ±13.8 (range, 29-87) years and 55 (67.9%) were male. The median OS time was 34.8 and 45 months in patients with LAR ≥ 5.5 (n = 50) and LAR < 5.5 (n = 31), respectively. Kaplan-Meier curves showed that with the increase in LAR there was reduced survival, but it was not statistically significant (p = 0.278). Multivariate analyses revealed that the positive lymph node ratio above 20% was an independent predictor in resectable gastric cancer patients (OR = 6.281, 95% CI: 1.135-34.767, p = 0.035). CONCLUSIONS:With the increase in LAR survival in gastric cancer decreased, but it was not statistically significant. Studies involving a large patient series are needed.

Introduction The aim of this study was to demonstrate whether sildenafil is effective in minimizing and/or eliminating hepatic ischemia/reperfusion injury effects. For this purpose, the authors experimentally performed biochemical and histopathological examinations of the included rats using the hepatic ischemia/reperfusion model. Materials and methods The authors used 40 animals, with 10 rats in each group, in this study. Ischemia was applied 30-45min with the hepatoduodenal ligament clamping, and then reperfusion is started. The rats were grouped as follows: the first group, only laparotomy; the second group, laparotomy and sildenafil; the third group, hepatic ischemia-reperfusion; and the fourth group, hepatic ischemia-reperfusion and sildenafil. During experimental studies, sildenafil capsules were opened, and appropriate dose required for animals had been created with the weighing scales. Then, the powder was diluted with saline. The authors gave sildenafil through oral gavage 15 minutes before the ischemia. 60min after starting the experiment in 1-2 groups and 30min after beginning reperfusion in 3-4 groups (60min after beginning the experiment in all groups), blood was taken from the animals for biochemical analysis, and the animals were sacrificed. Simultaneously liver, lung, and kidney tissues were removed for biochemical and histopathological examination. Results Based on plasma evaluation, total antioxidant status was lower (P=0.0274) in ischemia/reperfusion group compared with ischemia/reperfusion+sildenafil group. However, there was no difference between the groups regarding total oxidant status values (P=0.0274). When comparing total antioxidant status and oxidative stress index in liver tissue, a statistically significant difference was observed between groups (P=0.012766 and P=0.004081), but on comparing histopathological scores, there was no difference between groups (P=0.1244). Conclusion Sildenafil partly reduced the effects of hepatic ischemia-reperfusion injury on the liver and distant organs, although this difference was not statistically significant.